In the related art, surgery, such as neurosurgery, for example, brain tumors are typically excised through an open craniotomy approach guided by imaging. The data collected in these solutions typically consists of CT scans with an associated contrast agent, such as iodinated contrast agent, as well as MRI scans with an associated contrast agent, such as gadolinium contrast agent. Also, optical imaging is often used in the form of a microscope to differentiate the boundaries of the tumor from healthy tissue, known as the peripheral zone. Tracking of instruments relative to the patient and the associated imaging data is also often achieved by way of external hardware systems such as mechanical arms, radiofrequency, or optical tracking devices. As a set, these devices are commonly referred to as surgical navigation systems and are often cumbersome and provide inaccurate tracking.
Port-based surgery is a minimally invasive surgical technique where a port is introduced to access a surgical region of interest using surgical tools. Unlike other minimally invasive techniques, such as laparoscopic techniques, a port diameter is larger than a tool diameter. Hence, the tissue region of interest is visible through the port, wherein exposed tissue in a region of interest, at a depth few centimetres below the skin surface, is accessible through a narrow corridor in the port.
Several related art problems generally preclude or impair the ability to perform port-based navigation in an intra-operative setting. For example, the position of the port axis relative to a typical tracking device (TD) is a free and uncontrolled parameter that prohibits the determination of access port orientation. Further, the limited access which is available, due to the required equipment for the procedure, causes indirect access port tracking to be impractical and unfeasible. Also, the requirement for angulation of the access port to access many areas within the brain during a procedure makes navigation of the access port a difficult and challenging problem that has not yet been addressed.
Additionally, the climbing costs of healthcare, coupled with alarming rates of malpractice suits, have highlighted the need for an efficient and effective method of surgical training in the related art, e.g., in relation to neurosurgery. Gross malpractice payments aside, surgical errors increase hospitalization time and adversely affect the health of patients, resulting in death or injury. The majority of these errors have been attributed to lack of skill and experience on the part of medical personnel. A number of simulation tools have been used in the related art.
For instance, U.S. Patent Publication No. 20150347682 involves simulation by acquiring 2-D images, optionally including using X-rays, to generate 3-D or 4-D imaging. U.S. Patent Publication No. 20150347682 involves simulation by acquiring medical imaging data encoded in a standard video format. U.S. Patent Publication No. 20150086955 involves simulation of a tissue model configured so that one or more of the layers are in the form of a lattice structure rather than fully solid layers using silicone with 3-D printing.
In another example, U.S. Patent Publication No. 20140378995 involves a simulator having a surgeon's console with a software suite to simulate a surgical instrument and a training environment. This related art simulator has training exercises corresponding to difficulty levels, wherein, upon completion of a task, the user receives a report describing performance metrics and a composite score is calculated from these metrics in relation to the user's own performance.
In addition, in the related art, phantoms or simulators are used in surgical training. Certain sub-anatomical features present a development/manufacturing challenge in the related art. For example, brain ventricles are negative spaces within the brain that allow cerebral spinal fluid (CSF) to circulate and nourish the brain and provide protection against compression. A number of related art methods for preparing these structures have experienced many challenges, such as a related art method of creating voids or negative spaces, wherein balloons are inflated within a liquid hydrogel and subsequently cooled. After one freeze-thaw cycle (FTC), the balloon is removed from the hydrogel, whereby a scar is formed on the surface, thereby necessitating post-processing, such as back-filling with water and removal of air pockets that develop.
Accordingly, challenges experienced in the related art include inaccuracy in training surgeons to perform neurosurgery, especially in relation to situations involving real-time registration of a surgical trajectory in relation to the unique characteristics of a particular tissue types or sub-types, such as in relation to cerebral tissue. Therefore, a need exists for a surgery simulator that provides feedback in relation to the user's own performance, other users; performance, other statistical data, and ultimate performance goals, by way of a variety of metrics.